The challenge of detection and management of alcohol abuse among elders

Alcohol abuse and dependence, defined in the Diagnostic and Statistical Manual of Mental Disorders (3rd edition, revised), is a serious mental health problem in older adults. It affects an estimated 2.5 million older adults. The true extent of alcohol abuse and dependence among elders is likely even greater as many problem drinkers go undetected. Alcohol abuse can seriously predispose the elderly to accidents, nutritional deficiencies, and diseases, and eventually result in loss of independence. The purpose of this article is to (1) describe the profile of older alcoholics in the acute care setting who typically mask as medical management seekers, (2) relate some of the difficulties involved in accurately identifying the problem of elder alcohol abuse, and (3) suggest strategies to improve intervention by CNSs.